Your Areas of Expertise

Areas of Expertise

Expertise

1

Expertise

2

Expertise

3

Expertise

4

Expertise

Job Responsibilities

Describe your present duties and responsibilities. Include the number of people, amount of sales revenue, total assets under your managerial responsibility, the length of time you have held your present position, and your reporting responsibilities within the organization.

What do you find are the most challenging aspects of your job?

What do you see next in your career?

Program Expectations

What specific objectives do you have for attending The Executive Program (TEP)?

In what ways do you believe you will enhance the learning experience of the other TEP participants?

Billing Information (Required)

A fee of $34,900 for The Executive Program—which includes tuition, lodging, most meals, teaching materials, and certificate of participation—is due and payable upon acceptance of the participant.

Person to whom the invoice should be mailed:

Name: *

Title/Position: *

Company Name: *

Business Mailing Address: *

City: *

State/Province: *

Zip/Postal Code: *

Country: *

Business Phone: *

E-mail Address: *

Cancellation/Transfer Policy

Cancellations after 3 April 2017 are subject to fees amounting to 50% of tuition, $17,450.

Cancellations after 1 May 2017 are assessed the entire program fee. If necessary, the sponsoring company may, by agreement with the Director of Executive Education, substitute a replacement prior to 28 April 2017.

All transfers will incur a $6,500 transfer fee. One transfer per accepted applicant to the next subsequent offering is allowed. Transfer requests received less than 30 days before the start date will incur a $9,500 fee.

A transfer request followed by a subsequent cancellation will be subject to the applicable cancellation fees noted above.

All cancellations and transfers must be received in writing. Submit your request via e-mail to Casey Floyd, Director, Executive Education (FloydC@darden.virginia.edu), call +1-434-243-4400.

ALL cancellation/transfer requests must be received in writing.

25% Deposit is required to secure your registration for the program.

Remaining balance due 30 days prior to start date of the program.

As a matter of policy, the Darden Graduate School of Business Administration does not discriminate among applicants and participants on the basis of race, religion, sex, national origin, color, or disability.

Additional Information

How did you hear about this program?

Please provide name or specify:

E-mail Address of Person Recommending You (if applicable):

Acknowledgement

If accepted into TEP, I commit to being an active participant in all aspects of the program—in class, in learning teams, and in other program activities.

Submission of this online application form confirms the candidate's agreement to all terms and conditions as outlined in this application.*